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HomeMy WebLinkAbout020-1356-21-000 ti 0 4.09 m o 0 C y N Y 0 a 3 N _O O O _7 f0 N N CL C O 2 Q. r N 3 N a d C . 'Zt 3 f0 p CC d 401.'a CL m N O E t N Z N V ,O U U c O C C — N O O m w E N O N tC O E2 9 LL O O U` C 6 CD j N @ O N Q f0 O C �- i O N z y t acE 0;5 r 3ti y N z a m G ° y r- H Z ! � p • .x j O C (0 00 ° c ° a o z v' c 20 «o ! �- v w m z o U) H r a�i y Z c E d m d o 7 tm ID N d �-p Plr N r co O ° c N ° r E O c CC T C f6 M lV O =O N Q U N — z � z z '0 i y z Q E N N CO c E tm � d r V O. r+ N o CD N H d O N O N ?� 0 G d .n E @ N N {(5�. f/1 N O S � a m Z 0 •'w _ =aaa N a (D � o U) o to - 0 U rn rn Z "kftA � N 0 N � CO O � "O E 00 Z) co ° a (D O a o to c o ° ca E © o� 3 m m 0 d 0 E 0 � R 'D N V C N O y.a O O y 7 N C N N U .. W a C = • o 2 o Z° YCf) v� `m R € a CL m � m = r� a� r A c ov�ic°) g e q 0 « .k � EL Ma � a % kf / §c0 f i §kk k .ak $ o }k k z 2Ir &/ )k$ {J 2 21Re7 .2 e. =eo =c <wm2c o «_ B ,a 0) a �E $fk� « .. @0o I Z — « r � \ } � 2 /§ =I _> kBk_ 2 20S / t$ - J 2 0 0 $ w c C z _ §22 { c _ @�< e (D � c CC C 9 k�� \f/ 3�\kk\ \ o 2 c z w = — z .. 0 \ R 0 c 2 ■ E 3 ■ = 7 cc I U) 3 ■ g k / U) & � / \ \ I . CD d & k } b § § z 0 - B $ m « 2 j v M 7 2 £ K ) _ 2 �_ = h = E CO g 4) \)/ I 9 o _ _ t ® $\ k 04 k k k 0- 0 / § ) \ 'o ° R f k § - § ] G A © § 2 § / o ) / } ) J I $ § a $ ) a C 2 J a U) v ST. CROIX COUNTY ZONING DEPARTMENT AS BUILT SANITARY REPORT r A Owner Qb Property Address 1H a (3 K c C p rt c l - P City /State O%AWON la`s sc Legal Description: n d Lot Block Subdivision/CSM # 6 ((P Is a u N W 1 /4 N W t /4, Sec. T a 9 N -R_ft_W, Town of PNODS ®,� PIN # , SEPTIC TANK — DOSE CHAMBER — HOLDING TANK INFORMATION: Tank manufacturer W E Size ST/PC / Setback from: House Well P/L �f Pump manufacturer Model Alarm location (HOLDING TANKS ONLY) Setbacks ervice ro Vent to es a er Line Meter location Alarm location SOIL ABS016rTION SYSTEM: �uwvPH tt�uh Type of system: i I to - yjyD Width Length � S Number of Trenches ►.► Setback from: House Well P/L Vent to fresh air intake ELEVATIONS Description of benchmark PV C Elevation d a Description of alternate benchmark Elevation Building Sewer a a ST/HT Inlet U 3 ST Outlet ( V- 3 PC Inlet PC Bottom Header/Manifold U U Top of ST/PC Manhole Cover Distribution Lines ( ) i 0 � Z to ( ) (U , , � 5 l Cfs Bottom of System � J � U O D 5' U o u SF Final Grade ( 0 � w ( ) Date of installation t2/ 2 q Permit number 3 qq & State plan number Plumber's signature Q 64�� License number )D '-),9 0 Date 73 A U U Inspector G a � b i� Complete plot plan � I NOTICE: Please provide the following: • A plan view sketch showing everything within 100 feet of the system. • Two horizontal reference points to center of septic tank manhole cover. • Show alternate benchmark, if applicable. PLAN VIEW i Y) INDICATE NORTH ARROW ` Wisconsin Department of Commerce EM County Y T Safety and Buildings Division PRIVATE SEWAGE S INSPECTION REPO St. Croix GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No.: Personal information you provice may be used for secondary purposes [Privacy Law, s.15.04 ( 344628 Permit Holder's Name: ❑ City ❑ Village Q Town of: State Plan ID No.: *%& & Town of Hudson Insp. BM Elev.: BM Description: Parcel Tax No.: 6 6, b Q „ -�, / Cf f 4tJ� TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic , 2lfZ� Benchmark 1 &7 Dosing Alt. BM 3.1Z Aeration j � � , Bldg. Sewer Q�u /�, O' t7_(0 Holding St /Ht Inlet Zs t 0,3: ✓ TANK SET BA , CKJNFORMATION St/ Ht Outlet fff• Ito, 03 Vent to TANK TO P/ L ELL LD P ROAD Dt Inlet ---� - Air Intake Septic �� NA Dt Bottom ng NA Heade / Man. o /0 Aeration NA Dist. Pipe o �OSO /� 3(, Holding ot. System / ' V'L- 0 9 Y /a }, I f PUMP/ SIPHON INFORMATION Final Grade 9 Oct, & 7­1 Manufa turer Demand v � J S Model Nu er GPM TDH Li Friction System DH Ft Fi For emain Length 71 Dia. Dist. To Well SOIL ABSORPTION SYSTEM BED/TRENCH Width Lengt N . Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSIONS a DIMENSION SYSTEM TO P / Lj BL W LAKE/ STREAM EACHING Manu cter'r ►'�GJr/ SETBACK CHAMBER � INFORMATION TypeO ! f Model Number: System• ' �� o�� IJ� OR UNIT DI RIBUTION SYSTEM Head / Manif 3Y Distribution Pi ( x Hole Size x Hole Spacing Vent To Air Intake Length / V07 Dia Length Dia, Spacing SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over Depth Over xx Depth Of xx Seeded/ Sodded xx Mulched Bed /Trench Center Bed /Trench Edges Topsoil ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) Inspection #1: 1 2 -/Z-(/ 11 Inspection #2: ((/ Location: 9 88 Burch rJ ircle,.I d on, WI (NW1 /4, NW1/4, Section 14 T29N -R19W) - 14.29.19.208 V "t� Plan revision required? ❑ Yes MAO / Use other side for additional information. SBD -6710 (R.3/97) Date I spector's gnature Cert. No t ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: . e 4. ..°.e...... ..,. F.,.., ream °_, ° ...... ... .. ... ...... ..a.. m ..,,.. _ „ 3 €. x z' x .,. .............. _.... _<...� . :.... ....,..,.� .....ew. .... ,,,, y ..... . .. ° ........, ..... ,... ..,.,. .. ... ..... .. _ } i Z e = 8 r . F® i % € b f mm -------. 4� x 4 Pm 3 5 a � { ° x i { 3 I ,> wm° .. _. d ,.,„ ,. >N m.m,.m.° s s .�_.« , s °.� , e._ ... AD ,.,.. M �. ,. ee. ,. ..�' ........�..N. ,» e S € .. .....,.... d . _, �S ,.... em 5+.«..... ... d # »..a. 1 . m<,r .., �ve< ..., .6,: . °, �..° ,. -.,,. b., � ° °✓? _. ..., J o rm y.. .... .: 'd i a r E # d S v eve , i .. ... .......... .�.: m® E 3, d _�., % S E ` x S ar Safety and Buildings Division lfisCOnS %n SANITARY PERMIT APPLICATION 2 1 Box Washington Avenue Department of Commerce In accord with ILHR 83.05, Wis. Adm I�! Madison, WI 53707 -7302 9 1 • Attach complete plans (to the county copy only) for the system er not less ty + than 8 112 x 11 inches in size. :;' + S 1 _ C (.O kr *j'sP • Sta ry Permit Nu • See reverse side for instructions for completing this applicat' = L� tE:S� ita mber Personal information you provide may be used for secondary purposes 0 Check i f revisioh to previous application [Privacy Law, s. 15.04 (1) (m)]. . - -. 14;f S I, I , Sta R LD.Number I. APPLICATION INFORMATION - PLEASE PRINT ALL I A Property O ner Name Pro on M r - ,; )v S- M C (SK AL ) /a 1 T , N, R 9 E (or) W Property Owner's Mailing Address ^ A v Ike �, Block Numbe ) I $o As R1J DFC des ti City, St ite Zip ode Pho tuber Subdivisio Name or CSM N Der inn 8 s C, b ( 1 V 2��� Iran► c- nd II. T Y PE B LDING: (check one) ❑ State Owned E] i ty Nearest Road Public 1 or 2 Family Dwelling - No. of bedrooms roiag OF 4D34 N fn Ill BUILDING USE (If building type is public, check all that apply) Parcel Tax Number(s) 1 ❑ Apartment/ Condo OU --I SS (e — 2 ❑ Assembly Hall 6 ❑ Medical Facility/ Nursing Home 10 ❑ Outdoor Recreational Facility 3 ❑ Campground 7 ❑ Merchandise: Sales/ Repairs 11 ❑ Restaurant /Bar /Dining 4 ❑ Church/ School 8 ❑ Mobile Home Park 12 ❑ Service Station/ Car Wash 5 ❑ Hotel/ Motel 9 ❑ Office/Factory 13 ❑ Other: specify IV. TYPE OF PERMIT: (Check only one box on line A. Check box on line B, if applicable) A) 1. .R' New 2. ❑ Replacement 3_ ❑ Replacement of 4_ E] Reconnection of 5_ ❑ Repair of an -------- System ________ System _____________ Tank Only_________ Existing S _________Existing System B) ❑ A Sanitary Permit was previously issued. Permit Number Date Issued V. TYPE OF SYSTEM: (Check only one) Non - Pressurized Distribution Pressurized Distribution Experimental Other 11 ❑ Seepage Bed 21 ❑ Mound 30 ❑ Specify Type 41 ❑ Holding Tank 12,Seepage Trench 22 ❑ In- Ground Pressure , , 42 ❑Pit Privy 13 ❑ Seepage Pit X � 43 ❑ Vault Privy 14 ❑ System -In -Fill L _ Z , va(erS VI. ABSORPTION SYSTEM INFORMATION: 1_ Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate 5. Perc. Rae Sysste Elev. 7. / F Final Grade r � Requ sq. ft.) Proposed (sq. ft. (GalsJday /sq. ft.) (Min. /inch) � O Ele aticlr>, V x `L t �1r -}�2t eet Capacit VII. TANK in Ca gallo Total # of Prefab. Site Fiber Exper. INFORMATION Gallons Tanks Manufacturers Name Concrete Con- steel glass Plastic App New Existin strutted Tanks Tanks epticTank k /av0 E] E] 1:1 1 E] L n Chamberl Chamber ❑ I ❑ I ❑ ❑ 1 ❑ ❑ VI11. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name: (Print) Plumber's Signature: (No Stamps) MP /MPRSW No.: Business Phone Number: eeT Plumber's ress (Stre , City, State,7ip C de): ,, 1 �� o W 3 S uDyto IX. COUNTY / DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (includes ❑ Surcharge Fee) Groundwater ate Issued Issuing Agent Signature (No Stamps) - 'U( Approved Owner Given Initial j� Adverse Determination X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: �sYS>� .i�� �. was �� �� d�� >� so.� - sip »,�1�tr'o�•4 � �e�W ee•� y 3 "- Y�" �. SBD- 6398 (R.11/97) DISTRIBUTION: Original to County. One copy To: Safety & Buildings Division, Owner, Plumber INSTRUCTIONS r 1. A sanitary permit is vaI id for two (2) years. 2. Your sanitary permit may be renewed before the expiration date, and at a time of renewal any new criteria in the Wisconsin Administrative Code will be applicable. 3. All revisions to this permit must be approved by the permit issuing authority. 4. Changes in ownership or plumber requires a Sanitary Permit Transfer/ Renewal Form (SBD -6399) to be submitted to the county prior to installation 5. Onsite sewage systems must be properly maintained. The septic tank(s) must be pumped by a licensed pumper whenever necessary, usually every 2 to 3 years. 6. If you have questions concerning your onsite sewage system, contact your local code administrator or the State of Wistonsin Safety and Buildings Division, 608- 266 -3151. To be complete and accurate this sanitary permit application must include: I. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of where the system is to be installed. II. Type of building being served. Check only one and complete # of bedrooms if 1 or 2 Family Dwelling. III. Building use. If building type is public, check all appropriate boxes that apply. IV. Type of permit. Check only one on line A. Complete line B if permit is for tank replacement, reconnection, or repair. V. Type of system. Check appropriate box depending on system type. VI. Absorption system information. Provide all information requested for numbers 1 through 7. VII. Tank information. Fill in the capacity of every new /or existing tank, list the total gallons, number of tanks and manufacturer's name, indicate prefab or site constructed and tank material. Complete for all septic, pump /siphon and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR. VIII. Responsibility statement. Installing plumber is to fill in name, license number with appropriate prefix (e.g. MP, etc.); address and phone number. Plumber must sign application form. IX. County / DepartmentUse Only. X. County/ Department Use Only. Complete plansoid specifications not smaller than 8 1/2 x 11 inches must be submitted to the county. The plans must -- indlude the following: A) plot plan, drawn to scale or with complete dimensions, location of holding tank(s), septic tank(s) or other treatment tanks; building sewers; wells; water mains/water service; streams and lakes; pump or siphon tanks; distribution boxes; soil absorption systems; replacement system areas; and the location of the building served; B) horizontal and vertical elevation reference points; C) complete specifications for pumps and controls; dose volume; elevation differences; friction loss; pump performance curve; pump model and pump manufacturer; D) cross section of the soil absorption system if required by the county; E) soil test data on a 115 form; and F) all sizing information. ---------------------------------------------------------------------------------------------------- GROUNDWATER SURCHARGE 1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of regulated practices which can effect groundwater. The monies collected through these surcharges are used for monitoring groundwater contamination investigations and establishment of standards. L L7 V - 2 prn e- R101j KAY; N • AN ��N�� T. f °T 1 PVC. U -c j l oa 0 1 Nute� y MA I�d�p� If A �pc�F Ali q8A TYZON /U ra0 9nl 1 TF y (j.QnRvar� 0 to fIpU10 AW_ ii U O—W N C (jo.00 M-MMMM'"M c I) c ,c = 2 v E c � cn T (� i O x t C V 1 Q ~ EE w c ,c` x rn r N i r to I T � 3 o CL a n. Bt E o R E F� - w m c� � n o .v =Y v C4 Lum Ecu T cu CO �� �. C vi ..',' t C � J LL O Z m _N O D tttttvvv Q. • • • • 0 615 Wisconsin Department of Industry SOIL AND SITE EVALUATION REPORT Page 1 of 3 Labor and Human Relations Division of 6ratety & Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY Attach complete site plan on paper not less than 8 Y-2 ttinchesin size. Plan must include, but St. Croix not limited to vertical and horizontal reference J_�ection and,% of slope, scale or PARCEL I.D. # dimensioned north arrow and location and t o nearest road.. ; , 020- 1021 -00 �.i' DATE WED BY APPLICANT INFORMATION - PLEAS T ARP MAT10N\ PROPERTY OWNER: IROPERTY LOCATION . O OVT. LOT 1/4 1/4,S T N,R XNor) W Kernon Bast 1 :.,, ]VW IM PROPERTY OWNER':S MAILING ADDRESS ST CROIX ..� OT # BLOCK # I SUBD. NAME OR CSM # 94 Ct>u r; TY Gr an CITY, STATE ZIP CODE PH °' ❑CITY ❑VILLAGE ETOWN NEAREST ROAD Hudson WI. 54016 (715) New Construction Use [x] Residential / Number o rooms 4 (] Addition to existing building (] Replacement [ ] Public or commercial describe Code derived daily flow 600 gpd Recommended design loading rate • 7 bed, gpd /ft2 •8 trench, gpd /ft Absorption area required 858 bed, ft 750 trench, ft Maximum design loading rate • 7 bed, gpd /ft2 •8 trench, gpd /ft Recommended infiltration surface elevation(s) 106.60 ft (as referred to site plan benchmark) Additional design / site considerations trenches spaced to code 4 . o' below surface el. Parent material outwash Flood plain elevation, if applicable na ft S = Suitable for system CONVENTIONAL MOUND IN- GROUND PRESSURE I AT -GRADE SYSTEM IN FILL HOLDING TANK U = Unsuitable fors stem INS ❑ U ®S ❑ U ®S ❑ U EIS E7 U ® S ❑ U I EIS L U SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Texture Structure Consistence Roots GPD /ft Boring # Horizon in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trends 1 -9 2 9 -36 10yr 5/4 none sil lcsbk mfr gw if .2 .3 Ground 3 1 36-45 10 r 5/4 c2d7.5 r 5/6 sil lcsbk mfr 9W if .2 .3 elev. 11 4 145-84 Syr 4/6 none - -- cos osg ml na na .7 .8 Depth to It limiting L X0 factor 84 (0 (�b Remarks: Boring # 1 0 -8 10 r 3/3 none 1 2msbk mfr QW 2f .5 .6 2 8 -31 10 r 4/4 one sil lcsbk mfr w if .2 .3 ................. Ground 3 31 -84 5 r 4/6 none cos 0SQ ml na na .7 .8 elev..._ 11 ft. Depth to 2 limiting y a factor +84 A° Remarks: CST Name: -- Please Print Gary L. Steel Phone: 715 -246 -6200 Address: 1554 200th. Aye., New Ric mo WI 540J7 Signature: Date: 8 -20 -98 CST Number: m02298 or, X&/ PROPERTY OWNER Kernon Bast SOIL DESCRIPTION REPORT Page 2 -of 3. , PARCEL I.D. # 020 - 1021 -00 Depth Dominant Color Mottles Texture Structure Consistence Roots GPD /ft Boring # Horizon in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Tw& .................. 3. 1 _ mfr aw 2f .5 2 9 -38 10 r 5/4 none sil lcsbk mfr qw if .2 .3 Ground 3 38 -47 10 r 5/4 c2d7.5 r 5/6 sil lcsbk mfr aw if .2 .3 elev. 1 4 47 -84 5 r 4/6 none Depth to limiting - L O, i facto + `i +84 11 Z b Remarks: Boring # 1 0 -9 -1.0yr 3/3 none 1 2msbk mfr 2f 4 2 9 -25 10 r 4/4 none sil 2msbk mfr qw if .5 .6 Ground 3 25 -33 10 r 4/4 c2 7.5 r 5/6 sil lcsbk mfr qw na .2 .3 elev. 4 33 -84 5 r 4/6 none cos 0SQ ml na na .7 .8 1 06.2 ft. Depth to limiting factor +84" Remarks: Boring # 2 10 -30 10 r 5/4 none sil lcsbk mfr 9w if .2 .3 Ground 3 30 -84 7.5 r 4/6 none cos 0sq m1 na na .7 .8 elev. 106. 21. Depth to limiting factor +84" Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: SBD- 8330(8.05/92) STEEL'S SOIL SERVICE Gary L. Steel Kernon Bast 1554 200th Ave. CSTM2298 NW4NW4 S14- T29N - R19W New Richmond, WI 54017 MPRSW -3254 town of Hudson (715) 246 -6200 lot #21 -Grass Range Second addn. This soil evaluation was conducted to satisfy a zoning requirement, it may or may not be suitable for your use. The location of the test may or may not be as shown as permanent lot lines were not established at the time the test was conducted. N 1 =40' BM.= top of 1 pvc pipe @ el. 100' Alt. BM.= top of 1 pvc pipe C el. 106.00' � r \ 0 (e 3 Z` Gary L. Steel 8 -20 -98 a r Wisconsin pepartment of Industry SOIL AND SITE EVALUATION REPORT Page 1 of 3 tabor and Human Relations Division of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code EPARCELI.D. Attach complete site plan on paper not less than 8 1/ - >�hes in size. Plan must include, but x: not limited to vertical and horizontal reference ` �,�i�ection and,% of slope, scale or dimensioned, north arrow, and location and dirt o nearest road., -00 . DATE APPLICANT INFORMATION -PLEAS k*T A� , I I fI TtON\ PROPERTY OWNER: ROPERTY LOCATION OVT. LOT t!4 1 /4,S T N,R for W ) Kernon Bast ! -,,,� NW PROPERTY OWNER':S MAILING ADDRESS ST ;NO!X OT # BLOCK # I SUBD. NAME OR CSM # C�OUrj ?Y 948 LaBarae Rd. CITY, STATE ZIP CODE PH ❑CITY []VILLAGE RFOWN NEAREST ROAD Hudson WI. 54016 ( ) ` "- Addition to existing building [ � New Construction Use [x] Residential / Number of 6ed"rooms 4 [ 1 g g ] Replacement [ ] Public or commercial describe Code derived daily flow 600 g pd Recommended design loading rate • 7 bed, gpd /ft2 •8 trench, gpd/ft Absorption area required 858 bed, ft 750 trench, ft Maximum design loading rate • _ bed, gpd /ft2 •8 trench, gpd /ft Recommended infiltration surface elevation(s) 106.60 ft (as referred to site plan benchmark) Additional design / site considerations trenches spaced to code 4 - o' below surface e Parent material outwash Flood plain elevation, if applicable _ na ft S = Suitable for system CONVENTIONAL MOUND IN GROUND PRESSURE AT GRADE SYSTEM IN FILL HOLDING TANK U = Unsuitable fors stem ® S El ® S El U ®S ❑ U El g7 U ®S ❑ U ❑ S L U SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Structure Roots GPD /ft Boring # Horizon Texture Consistence Bw in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trer>ch ..1:.... 1 0- 10yr 4/4 none 2msbk mfr aw 2 9 -36 10yr 5/4 none sil lcsbk mfr gy if .2 .3 Ground 3 36 -45 10 r 5/4 c2d7.5 r 5/6 sil lcsbk mfr gy if .2 .3 ev. 1 Aev 4 45 -84 �5yr 4/6 none cos osg ml na na .7`:. .8 Depth to f actor /07. �� 2 ` factor +84 (�b Remarks: Boring # 7.5 .0 -8 10 r 3 3 none 1 2msbk mf r 2 8 -31 10 r 4 4 none sil lcsbk mfr if " 3 31 -84 5 r 4/6 none cos os ml na na .7 .8 Ground elev. 11 ft. Depth to limiting factor +84 Remarks: CST Name: -- Please Print Gary L. Steel Phone: 715- 246 -6200 Address: 1554 200th. aye., New Ric mo WI 54W7 Signature: Date: 8 - - CST Number: m02298 PROPERTY OWNER Kernon Bast SOIL DESCRIPTION REPORT Page 2 of 3 PARCELI.D.#t 02 0 - 1021 -00 Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Bounclary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench 3 ; ? 1 - mfr . . ' . . "'' "" 2 9 -38 1O r 5/4 none sil lcsbk mfr CTw 1f .2 .3 Ground 3 38 -47 10 r 5 4 c2d7.5 r 5/6 si lcsbk mfr aw if .2 elev. 1 4 47— 5 r 4/6 none Depth to limiting ti factor Q/ 07. 7 + 84 11 Remarks- 2 Boring # 4 = <` 2 9 -25 10 r 4/4 none sil 2msbk mfr qw if .5' .6 Ground 3 25 -33 10 r 4/4 c2 7.5 r 5/6 sil lcsbk mfr w na .2:: .3 e 4 33 -84 5 r 4/6 none cos os ml na na .7 .8 1 2 ft. Depth to limiting factor +84 Remarks: Boring # +t iji :� > <> 2 10 -30 10 r 5 4 none sil lcsbk mfr qw if .2 .3 Ground 3 30 -84 7.5 r 4/6 none cos 0SQ ml na na .7 .8 elev. 106. 2t. Depth to limiting factor +84" Remarks: Boring # ti•:: Ground elev. ft. Depth to limiting factor Remarks: con oo�nio ne mn Y STEEL'S SOIL SERVICE Gary L. Steel o Ba s t 1554 200th Ave. CSTM2298 NW44 NWs14 T29N -R19W New Richmond, WI 54017 MPRSW -3254 town of Hudson (715) 246 -6200 lot #21 -Grass Range second addn. This soil evaluation was conducted to satisfy a zoning requirement, it may or may not be suitable for your use. The location of the test may may not be as shown as permanent lot lines were not established at the time the test was conducted. N 1 =40' _ BM.= top of 1k pvc pipe C el. 100' Alt. BM.= top of 12" pvc pipe @ e .106.00' o � 32-' Gary L. steel 8 -20 -98 ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATIO FORM Owner/B uyer Mailing Address Am J10-P J2 5) • � ' Property Address AL4 A oA 04- (Verification required from Planning Department for new construction) �1 A City/State _ I' uD) ory W J G Parcel Identification Number _ 0-LA 0 - -00 LEGAL DESCRIPTION Property Location y,, � ' /,, Sec. , T I N -RLW, Town of H v - dd ps Subdivision Go ASS �0 �d �l , Lot # _. Certified Survey Map # Volume . Page # Warranty Deed # Volume / � Page # Spec house 0 yes Xno Lot lines identifiable A yes O no SYSTEM MARazmNcE Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewater disposal system is is proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. Uwe, the undersigned have read the above.requiirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin 'Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 . da the a expiration date. i SI ATURE OF APPLICANT DATE O ON (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of pro described above, by a of a ,warranty deed recorded in Register of Deeds Office. 2 1.311.9 SK3NATURE OF A 7 DATE * * * * ** Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning Department. * *• * ** ** Include with this application: a stamped warranty deed from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed c� vo i .1448PA GE 304 y STATE BAR OF WISCONSIN FORM 2 — 1982 60,8414 KATHLE O H WALSH WARRANTY DEED DEEDS REGISTER OF DEEDS DOCUMENT NO. ST CROIX CO., WI RECEIVED FOR RECORD This Deed, made between KERNON J. BAST and 08 -11 -1999 10:45 AM DONALDA J. SPEER -BAST, husband and wife, WARRANTY DEED EXEMPT N ,Grantor CERT COPY FEE: DANIEL J. MCGRAW and DENISE M. COPY FEE: 2.00 conveys and warrants to TRANSFER FEE: 113.70 MCGRAW, husband a wife, RECORDING FEE: 10.00 PAGES: 1 ,Grantee Witnesseth, That the said Grantor, for valuable consideration, conveys to the Grante THIS SPACE RESERVED FOR RECORDING DATA NAME AND RETURN ADD the following described real estate in St. Croix County, ;, c` ' ^� rI �� - State of Wisconsin: � �v , c, c) S Lot 21, plat of Grass Range Second Addition, d'vo, I LOT sycl( �.. Town of Hudson, St. Croix County, Wisconsin. PARCEL IDENTIFICATION NUMBER This is not homestead property. (is) (is not) Exception to warranties: easements, restrictions, and rights -of -way Dated this 5 day of August A.D., 19 9 9 on J. Bast SEAL) Donalda J. Speer -Bast (SEAL) (SEAL) (SEAL) AUTHENTICATION ACKNOWLEDGMENT Signature(s) State of Wisconsin, ss. St. Croix County. ` authenticated this day of 19 Personally came before me this day of August 19 9 9 , the above named Kernon J. Bast and Donalda J. Speer -Bast TITLE: MEMBER STATE BAR OF WISCONSIN (If not, authorized by §706.06, Wis. Stats.) to me known to be the person s who executed the foregoing instrument and acknowledge the same. THIS INSTRUMENT WAS DRAFTED BY DIANE M. BARRON Kernon J. Bast Notary Public a consin H rr d G o n, WT 54016 Notary Public, C .h If O L rL_ County, Wis. (Signatures may be authenticated or acknowledged. Both are not My commission is permanent. (If not, state expiration date: necessary.) • Names of persons signing in any capacity should by typed or printed below their signatures. STATE BAR OF WISCONSIN Wisconsin Legal Blank Co., Inc. WARRANTY DEED Form No. 2 — 1982 Milwaukee, Wis. x O • F x W v W O CC G NN T� --r w Z Z7 0 Ll Z 2 M .. .. W 77 r 1�D Ll . 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